TX HHS Form 8611. Pre-Enrollment MHM Authorization Request

The TX HHS Form 8611, Pre-Enrollment MHM Authorization Request, is a crucial document for individuals seeking minor home modifications (MHMs) prior to enrollment in the Home and Community-based Services (HCS) Program. This form helps facilitate the authorization process by providing essential information about the requested MHM and assessments.

The form requires submission of specific documentation, including service planning team meeting notes, written assessments from licensed professionals, and bids from vendors when necessary. The Local Intellectual and Developmental Disability Authority (LIDDA) is responsible for submitting this packet to the Texas Health and Human Services Commission (HHSC) Program Enrollment/Utilization Review Unit. Upon submission, HHSC will review the request and agree or disagree to pay the program provider for the requested MHM.

Key features of this form include the requirement for service planning team meeting documentation, written assessments from licensed professionals, and bids from vendors when necessary. The form also outlines follow-up actions, such as submitting Form 8612, TAS/MHM Payment Exception Request, if the applicant does not enroll within 30 days of their planned enrollment effective date.

• The TX HHS Form 8611 is used for pre-enrollment MHM authorization requests in the Home and Community-based Services (HCS) Program.
• The form requires submission of specific documentation, including service planning team meeting notes, written assessments from licensed professionals, and bids from vendors when necessary.
• HHSC will review the request and agree or disagree to pay the program provider for the requested MHM.